Recall accuracy for the symptoms of a major depressive episode among clinical trial participants

Dunlop, Boadie W.; Granros, Maria; Lechner, A.; Mletzko-Crowe, Tanja; Nemeroff, Charles B.; Mayberg, Helen S.; Craighead, W. Edward

doi:10.1016/j.jpsychires.2019.03.008

Cited by 14 publications

(10 citation statements)

References 30 publications

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“…This discrepancy may be due to reduced statistical power stemming from group comparisons using a two year cut off instead of a correlation analysis employing a continuous measure of episode duration. We used group analysis because retrospective selfreport for duration of illness is often highly inaccurate, so categorical classification is a more conservative approach to the data (30). Our analysis also showed no statistical relationship between depression severity and volume reduction at baseline as previously reported by Frodl et al (31) and Nils et al (32).…”

Section: Discussionsupporting

confidence: 70%

Treatment-Specific Hippocampal Subfield Volume Changes With Antidepressant Medication or Cognitive-Behavior Therapy in Treatment-Naive Depression

et al. 2021

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Background: Hippocampal atrophy has been consistently reported in major depressive disorder with more recent focus on subfields. However, literature on hippocampal volume changes after antidepressant treatment has been limited. The first-line treatments for depression include antidepressant medication (ADM) or cognitive-behavior therapy (CBT). To understand the differential effects of CBT and ADM on the hippocampus, we investigated the volume alterations of hippocampal subfields with treatment, outcome, and chronicity in treatment-naïve depression patients.Methods: Treatment-naïve depressed patients from the PReDICT study were included in this analysis. A total of 172 patients who completed 12 weeks of randomized treatment with CBT (n = 45) or ADM (n = 127) were included for hippocampal subfield volume analysis. Forty healthy controls were also included for the baseline comparison. Freesurfer 6.0 was used to segment 26 hippocampal substructures and bilateral whole hippocampus from baseline and week 12 structural MRI scans. A generalized linear model with covariates of age and gender was used for group statistical tests. A linear mixed model for the repeated measures with covariates of age and gender was used to examine volumetric changes over time and the contributing effects of treatment type, outcome, and illness chronicity.Results: Of the 172 patients, 85 achieved remission (63/127 ADM, 22/45 CBT). MDD patients showed smaller baseline volumes than healthy controls in CA1, CA3, CA4, parasubiculum, GC-ML-DG, Hippocampal Amygdala Transition Area (HATA), and fimbria. Over 12 weeks of treatment, further declines in the volumes of CA1, fimbria, subiculum, and HATA were observed regardless of treatment type or outcome. CBT remitters, but not ADM remitters, showed volume reduction in the right hippocampal tail. Unlike ADM remitters, ADM non-responders had a decline in volume in the bilateral hippocampal tails. Baseline volume of left presubiculum (regardless of treatment type) and right fimbria and HATA in CBT patients were correlated with a continuous measure of clinical improvement. Chronicity of depression had no effect on any measures of hippocampal subfield volumes.Conclusion: Two first-line antidepressant treatments, CBT and ADM, have different effects on hippocampal tail after 12 weeks. This finding suggests that remission achieved via ADM may protect against progressive hippocampal atrophy by altering neuronal plasticity or supporting neurogenesis. Studies with multimodal neuroimaging, including functional and structural analysis, are needed to assess further the impact of two different antidepressant treatments on hippocampal subfields.

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Section: Discussionsupporting

confidence: 70%

Treatment-Specific Hippocampal Subfield Volume Changes With Antidepressant Medication or Cognitive-Behavior Therapy in Treatment-Naive Depression

et al. 2021

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“…Recall of core depressive symptoms showed high accuracies around 90% for depressive episodes up to two years past. However, the study by Dunlop et al only investigated recall of symptom types but not intensities [44].…”

Section: Discussionmentioning

confidence: 99%

Age as a moderating factor of treatment resistance in depression

et al. 2023

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Background: Treatment resistant depression (TRD) is an important clinical challenge and may present differently between age groups. Methods: 893 depressed patients recruited within the framework of the European research consortium "Group for the Studies of Resistant Depression" (GSRD) were assessed by generalized linear models regarding age effects (both as numerical and factorial predictor) on treatment outcome, number of lifetime depressive episodes, hospitalization time and duration of the current episode. Effects of age as numerical predictor on severity of common depressive symptoms, measured with Montgomery-Åsberg depression rating scale (MADRS) for two time points, were assessed by linear mixed models respectively for patients showing TRD and treatment response. A corrected p threshold of 0.001 was applied.Results: Overall symptom load reflected by MADRS (p < 0.0001) and lifetime hospitalization time (p < 0.0001) increased with age in TRD patients but not treatment responders. In TRD, higher age was predicting symptom severity of inner tension, reduced appetite, concentrations difficulties and lassitude (all p ≤ 0.001). Regarding clinical significance, older TRD patients were more likely to report severe symptoms (item score > 4) for these items both before and after treatment (all p ≤ 0.001). Conclusion:In this naturalistic sample of severely ill depressed patients, antidepressant treatment protocols were equally effective in addressing TRD in old age. However, specific symptoms such as sadness, appetite and concentration showed an age-dependent presentation, impacting residual symptoms in severely affected TRD patients and calling for a precision approach by a better integration of age profiles in treatment recommendations.

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“…The respective variables reflecting a reduction of depressive symptoms during the current MDE might be, hence, regarded as longitudinal measures providing hints towards causality. We are aware that this approach is inferior to randomized-controlled, prospective conditions; however, in light of the fact that MDD patients were previously shown to adequately recall symptoms for a considerable period of time [ 20 ] and that many rating scales consider symptoms of MDD retrospectively, we deem our procedure justifiable. Additionally, to minimize such associated bias, all our raters were experienced psychiatrists undergoing extensive training in the respective scales.…”

Section: Discussionmentioning

confidence: 99%

The sociodemographic and clinical profile of patients with major depressive disorder receiving SSRIs as first-line antidepressant treatment in European countries

Fugger

Bartova

Fabbri

et al. 2022

Eur Arch Psychiatry Clin Neurosci

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Introduction Due to favorable antidepressant (AD) efficacy and tolerability, selective-serotonin reuptake inhibitors (SSRIs) are consistently recommended as substances of first choice for the treatment of major depressive disorder (MDD) in international guidelines. However, little is known about the real-world clinical correlates of patients primarily prescribed SSRIs in contrast to those receiving alternative first-line ADs. Methods These secondary analyses are based on a naturalistic, multinational cross-sectional study conducted by the European Group for the Study of Resistant Depression at ten research sites. We compared the socio-demographic and clinical characteristics of 1410 patients with primary MDD, who were either prescribed SSRIs or alternative substances as first-line AD treatment, using chi-squared tests, analyses of covariance, and logistic regression analyses. Results SSRIs were prescribed in 52.1% of MDD patients who showed lower odds for unemployment, current severity of depressive symptoms, melancholic features, suicidality, as well as current inpatient treatment compared to patients receiving alternative first-line ADs. Furthermore, patients prescribed SSRIs less likely received add-on therapies including AD combination and augmentation with antipsychotics, and exhibited a trend towards higher response rates. Conclusion A more favorable socio-demographic and clinical profile associated with SSRIs in contrast to alternative first-line ADs may have guided European psychiatrists’ treatment choice for SSRIs, rather than any relevant pharmacological differences in mechanisms of action of the investigated ADs. Our results must be cautiously interpreted in light of predictable biases resulting from the open treatment selection, the possible allocation of less severely ill patients to SSRIs as well as the cross-sectional study design that does not allow to ascertain any causal conclusions.

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Recall accuracy for the symptoms of a major depressive episode among clinical trial participants

Cited by 14 publications

References 30 publications

Treatment-Specific Hippocampal Subfield Volume Changes With Antidepressant Medication or Cognitive-Behavior Therapy in Treatment-Naive Depression

Treatment-Specific Hippocampal Subfield Volume Changes With Antidepressant Medication or Cognitive-Behavior Therapy in Treatment-Naive Depression

Age as a moderating factor of treatment resistance in depression

The sociodemographic and clinical profile of patients with major depressive disorder receiving SSRIs as first-line antidepressant treatment in European countries

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